This certificate from Intellipass confirms that a student named STUDENT NAME completed a property pre-license education course on October 8, 2015. The course was conducted in accordance with the standards of the Washington State Office of the Insurance Commissioner. Both the instructor and student certified that STUDENT NAME personally completed the required coursework to satisfy Washington's pre-licensing education regulations for property insurance. The certificate is valid for 12 months from the completion date.

1. State of Washington
Approved
Pre-License Education
CERTIFICATE OF COMPLETION
STUDENT NAME:STUDENT NAME:
PRELICENSE COURSE IDENTIFICATIONPRELICENSE COURSE IDENTIFICATION
Provider’s Name: INTELLIPASSProvider’s Name: INTELLIPASS
Provider’s Location: 1925 SOUTH 341ST
PLACE, FEDERAL WAYProvider’s Location: 1925 SOUTH 341ST
PLACE, FEDERAL WAY
Provider’s School Code Number: 12935Provider’s School Code Number: 12935
COURSE SUBJECT Credit Hours Completion DateCOURSE SUBJECT Credit Hours Completion Date
2020
Instructor: Instructor No.Instructor: Instructor No.
OROR
Self-Study Instructor No.Self-Study Instructor No.
INSTRUCTOR CERTIFICATIONINSTRUCTOR CERTIFICATION
I hereby certify this course was conducted as approved by the Washington State Office of the
Insurance Commissioner. I further certify the person whose name appears above did personally
complete this course on the date indicated.
I hereby certify this course was conducted as approved by the Washington State Office of the
Insurance Commissioner. I further certify the person whose name appears above did personally
complete this course on the date indicated.
Signature: Date:Signature: Date:
STUDENT CERTIFICATIONSTUDENT CERTIFICATION
I hereby certify that I personally completed the course listed above in the manner required to
satisfy the pre-license education regulation.
I hereby certify that I personally completed the course listed above in the manner required to
satisfy the pre-license education regulation.
Signature: _______________________________________ Date: ___________________Signature: _______________________________________ Date: ___________________
This certificate valid for 12 months from completion date. PLE-CERT (06-2009)This certificate valid for 12 months from completion date. PLE-CERT (06-2009)
Lynn Havens
Property 10/08/2015
9999
10/08/2015
Self-Study 9999